Provider Demographics
NPI:1871680330
Name:AMERITEX SERVICES, INC
Entity Type:Organization
Organization Name:AMERITEX SERVICES, INC
Other - Org Name:AMERICAN GERI SERVICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-592-4975
Mailing Address - Street 1:1321 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68108-3406
Mailing Address - Country:US
Mailing Address - Phone:402-592-4975
Mailing Address - Fax:402-592-2680
Practice Address - Street 1:1321 S 20TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-3406
Practice Address - Country:US
Practice Address - Phone:402-592-4975
Practice Address - Fax:402-592-2680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0961649Medicaid
IA0961649Medicaid